2016-04-14
Colleen Hartland - Speech in Parliament in response to the Health Complaints Bill 2016. The Greens warmly welcome the introduction of the Health Complaints Bill 2016 to Parliament. We believe it is a much needed reform of the current health services commissioner’s role. We have seen in recent times how the existing powers and rules surrounding the health services commissioner have failed.
We just need to look at the example of the Bacchus Marsh hospital. There were multiple system failures that led to a situation where doctors who possibly were acting outside of their skill base were not being supervised or questioned about what they were doing, where the hospital board failed to act, where the health services commissioner had insignificant powers to intervene, where rules regarding complaint procedures prohibited staff and the nurses and midwives union from reporting the situation, and where the government was not made aware of what was going on. There were also massive failures by the Australian Health Practitioner Regulation Agency (AHPRA), which failed to investigate complaints against a number of doctors, and this clearly made that quite terrible situation go on for far too long.
The Bacchus Marsh hospital situation was, I think, an example of a catastrophic system failure and a horrific situation for all families concerned. But I would like to say that the actions of the Minister for Health, once she had all the facts in place — the way she made sure that the families knew what was happening before the press knew — were the appropriate actions to take. Certainly when I asked for a briefing about what had occurred, that was supplied to me very quickly. But I think it is an example of how things can go wrong on a number of different levels.
The Greens are very pleased that AHPRA is under review, and I have to say quite clearly that when this legislation came to us several years ago — about having the AHPRA regulation — we were very much in favour of it. We thought that a national scheme was the way to go. We absolutely supported it, but clearly there are deficiencies and we hope that these sweeping reforms will actually make AHPRA fulfil what was its original purpose.
Here in Victoria the reform of the health services commissioner and the Health Services (Conciliation and Review) Act 1987 are now desperately needed, so the Greens are very pleased to see this bill come forward. This reform comes off the back of a number of reviews by expert panels and the health services commissioner in consultation with key stakeholders in recent years. As Ms Wooldridge indicated, a number of those organisations look at this very favourably. We hope that this level of review in consultation means that this legislative framework will be a vast improvement.
The Health Complaints Bill replaces the Health Services (Conciliation and Review) Act 1987 and creates a new health complaints commissioner role. The new commissioner will have oversight of health services as a whole as well as practitioners not covered by AHPRA. The commissioner can, as in the past, undertake activities to resolve disputes, but hopefully the new bill will make that process quicker and more efficient. Certainly it seems to be an ongoing complaint you hear from people who have used health services and who are making complaints that it seems to take an extraordinary amount of time for these issues to be resolved or even investigated, allowing parties to avoid expensive court cases by having conciliation. The new framework allows verbal as well as written complaints, which will improve access to the complaints system.
The new commissioner role is not the toothless tiger that it was in the past, and the commissioner will have investigatory powers that they can initiate without a formal complaint being made. The commissioner can prohibit unethical or negligent health practitioners from practising. The commissioner will have the power to make recommendations for quality improvements for health services and practitioners, which the commissioner can follow up and hold them to account. The commissioner can review data, exchange information with different oversight bodies and require data from health services in order to identify problems within the system. The commissioner can also hold public inquiries at the request of the minister or the Parliament. I believe these are necessary new and improved powers.
A key test for the Greens regarding this new commissioner role and the associated framework is not only that it can stop dodgy and unqualified people from practising and making false claims, but it could have intervened to stop the debacle at the Bacchus Marsh Hospital. Our assessment is that under this framework there are a number of ways the new commissioner could have been alerted to the situation and could have intervened.
Third parties can now report complaints, allowing staff to come forward or the union on their behalf. There are better whistleblower protections in this law. Under the new powers, the commissioner could have held the health board to account and investigated the health service. The commissioner also would have been able to share information with AHPRA and could have alerted the government that it felt AHPRA was dragging its feet.
While the Victorian legislation certainly cannot fix the problems with AHPRA, it can do a lot in other areas that will help pick up where AHPRA is failing. All these improvements indicate that this should be a vastly better system that stops significant harm from occurring quickly. It is not just situations like Bacchus Marsh. Complaints mechanisms are critical for improving the quality of our health system and ensuring mistakes are not repeated for other patients. The bill updates complaint mechanisms and conciliation powers and modernises dispute resolution and the conciliation mechanism. It also allows third parties, such as carers, family members or members of the public, to alert the commissioner to problems in a health service or in a situation where care is provided by a practitioner.
An important part of the legislation is that it widens the remit of the commissioner. It allows the commissioner to investigate health practitioners not covered by AHPRA and who previously were not covered by any complaints mechanism. These include many commonly utilised health services, such as naturopaths, massage therapists, counsellors, doulas and many more. It introduces a code of practice for these practitioners, which we think is very good. It is important that these practitioners are covered by the complaints mechanisms. Professionals in these industries do not want to see dodgy, unqualified people using poor practices resulting in their reputations and the reputation of their profession being tarnished and causing harm or financial loss to consumers. This bill will enable complaints to be made against such practitioners, forcing them to lift their game or stop practising.
One concern the Greens had with this bill was to ensure that alternative and complementary therapies would not be unduly picked on or unnecessarily restricted as part of this reform. We understand that many alternative therapies have not undergone rigorous scientific testing in the same way Western medicine has, but also we know that practically some of them can be very beneficial to consumers. Thus practitioners do make claims about the benefits of their services. We wanted to ensure that a reasonable approach would be taken to such claims, and in discussions with the government we believe it is not the intention of this bill to in any way impede the operation of those services or to inhibit claims made, as long as they do not put the public at risk. For example, it would be acceptable to claim that nutrition support, herbs and meditation can be of benefit to people being treated for cancer, but it would not be acceptable to claim that they cure cancer, so we make that distinction. It could be helpful in the treatment, but it cannot cure. Those are the kinds of claims that we do not want to see, because they can financially ruin people who are in a desperate situation.
Ms Mikakos — Or as a substitute for vaccination.
Ms HARTLAND — I thank Ms Mikakos. As there is no evidentiary basis for such claims, it does potentially put people’s lives at risk. So if someone complains to the commission about such a claim being made, the commissioner could intervene to stop them claiming such unsubstantiated facts. I believe any quality practitioner will have no problem with this and in fact would welcome such interventions to weed out problems in the industry. The commissioner can also issue public alerts, which might be necessary in the case of someone causing widespread risks to public health.
A part of this bill that the Greens also very warmly welcome is that the new commissioner will have the power to stamp out the shocking, terrible practice of gay conversion therapy. I was quite shocked to realise that this was still occurring, and I suggest that people want to understand this better. Bob Brown, the former federal Leader of the Greens, has written extensively on this and on what happened to him in his youth, and I am aware of other friends who are in my age group who underwent this terrible therapy. It does not work. It is evil. I do not quite understand why it is that extreme Christian groups believe that they have to try to change someone’s very being. As I said, I was really shocked to learn that this practice is still taking place in Victoria, and it causes significant harm to individuals. We hope that this practice can now be weeded out once and for all, and also named for what it is — homophobic hatred.
I have consulted with a range of stakeholder groups, and most are broadly supportive of this reform. Some concerns were raised by the Australian Dental Association, and thus I will ask some questions during the committee of the whole.
In conclusion, the Greens commend this bill to the house. We think it is a long time coming, and we do believe that it will be of great benefit. The Greens also look forward to a similar overhaul of the disability services commissioner role in the near future and hope the outcome of the current inquiries into abuse of people with disabilities in Victoria will be that it can be much better dealt with in the future.